ผลของโปรแกรมการดูแลช่องปากร่วมกับการบำบัดด้วยความเย็นต่อภาวะเยื่อบุช่องปากอักเสบในผู้ป่วยมะเร็งที่ได้รับยาเคมีบำบัด

Abstract

Mucositis is a common complication for cancer patients receiving chemotherapy, having both physical and psychological effects on them. Therefore, prevention and management are undertaken to reduce oral mucositis’ occurrence and severity. The purpose of this quasi-experimental study was to compare the incidence of oral mucositis among cancer patients receiving chemotherapy between one group receiving the program and one receiving normal nursing care and to compare onset time, time duration of symptoms, and the severity of mucositis between the two groups. Purposive sampling was used to selected 52 chemotherapy-treated cancer patients from the Chemotherapy Unit, Chomthong Hospital, who were divided into an experimental group and a control group of 26 participants each. The research tools included: 1) an oral care program combined with cryotherapy which the researcher developed from a literature review and which consisted of 2 components: i) oral care, consisting of individual oral care knowledge provided through media presentations, and oral care equipment (soft toothbrush, toothpaste, oral mirror, normal saline mouthwash) and ii) cryotherapy, which involved sucking ice continuously for 30 minutes while receiving chemotherapy; and 2) an oral mucositis symptoms assessment from the World Health Organization (WHO, 1979). The data collection tools consisted of a personal information questionnaire, which included information about the patient’s cancer; a form for recording oral symptoms at home; and a follow-up form to encourage continuous oral care by telephone. Data were analyzed using descriptive statistics, chi-square test, Fisher’s exact test, independent t-test, and the Mann-Whitney U test. The results showed that the incidence of oral mucositis in the experimental group receiving the oral care program combined with cryotherapy (5 people, 19.2%) was less than that in the control group (26 people, 100%). There was a statistically significant (p < .001) onset time of oral mucositis in the experimental group (x ̅= 6.6, S.D. = 0.54), significantly longer than that of the control group (x̅ = 3.92, S.D. = 0.68) (p < .001). The severity of oral mucositis in the experimental group (x 2.80, S.D. = 0.44) was lower than that in the control group (x ̅= 4.73, S.D. = 1.18) with statistical significance (p < .001). The degree of severity of oral mucositis in the experimental group (x = 0.19, S.D. = 0.40) was significantly less than that of the control group (x= 1.88, S.D. = 0.51) (p < .001).